当归四逆汤联合甲氨蝶呤治疗类风湿关节炎临床观察
Danggui Sini Decoction Combined with Methotrexate in Treatment of Rheumatoid Arthritis: A Clinical Observation
  
DOI:
中文关键词:  类风湿关节炎  当归四逆汤  甲氨喋呤  炎性因子
英文关键词:Rheumatoid arthritis  Danggui Sini Decoction  Methotrexate  Inflammatory factor
基金项目:国家自然科学基金项目(81501866);江苏省六大人才高峰项目(2015-WSN-096);南通科技计划项目(MS12015102)
作者单位
范建波,逸 弘,崔胜宇,刘 巍 南通市第一人民医院骨科江苏 南通 226001 
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中文摘要:
      目的 观察当归四逆汤和甲氨喋呤治疗类风湿关节炎的疗效及其对炎性因子水平的影响。方法 将108例类风湿关节炎患者随机分为对照组和观察组,每组54例。对照组给予甲氨喋呤治疗,观察组在对照组疗法基础上加用当归四逆汤。观察两组临床疗效和主要临床症状改善情况,采用魏氏法检测红细胞沉降率(erythrocyte sedimentation rate, ESR),采用免疫单扩散法检测血清C反应蛋白(C-reactive protein, CRP),采用ELISA法检测血清抗环瓜氨酸多肽(cyclic citrulline polypeptide,CCP)抗体、白细胞介素-6(interleukin-6, IL-6)、IL-17、IL-23和IL-1β水平,采用速率散射比浊法检测血清类风湿因子(rheumatoid factor,RF)水平。结果 两组患者临床疗效分布比较,差异有统计学意义(P<0.05)。两组患者治疗后晨僵时间、压痛关节数和肿胀关节数均较治疗前明显减少(P<0.05),观察组较对照组减少更为明显(P<0.05)。两组患者治疗后血清CRP、ESR、抗CCP抗体、RF、IL-6、IL-17、IL-23、IL-1β水平均较治疗前明显降低(P<0.05),观察组较对照组降低更为明显(P<0.05)。结论 当归四逆汤联合甲氨喋呤可明显提高类风湿关节炎的疗效,改善临床症状,降低血清炎性因子水平。
英文摘要:
      Objective To investigate the clinical effect of Danggui Sini Decoction combined with methotrexate in the treatment of rheumatoid arthritis and its effect on inflammatory factors. Methods A total of 108 patients with rheumatoid arthritis were randomly divided into observation group and control group, with 54 patients in each group. The patients in the control group were given methotrexate, and those in the observation group were given Danggui Sini Decoction in addition to the treatment in the control group. The two groups were compared in terms of clinical outcome, improvement in clinical symptoms. The erythrocyte sedimentation rate (ESR) was assayed using Westergren method, the serum levels of C-reactive protein (CRP) was assayed using radioactive single radial diffusion, and anti-cyclic citrulline polypeptide (CCP) antibody, rheumatoid factor (RF), interlukin-6 (IL-6), interleukin-17(IL-17), interleukin-23(IL-23), and interleukin-1 beta(IL-1β) were assayed using ELISA. Results There was no significant difference in the distribution of clinical outcomes between the two groups (P<0.05). After treatment, both groups had significant reductions in the duration of morning stiffness and the numbers of joints with tenderness or swelling (P<0.05), and the observation group had significantly greater reductions than the control group (P<0.05). After treatment, both groups had significant reductions in ESR and serum levels of CRP, anti CCP antibody, RF, IL-6, IL-17, IL-23, and IL-1β (P<0.05), and the observation group had significantly greater reductions than the control group (P<0.05). Conclusion Danggui Sini Decoction combined with methotrexate can improve the outcome and clinical symptoms of rheumatoid arthritis and reduce serum levels of inflammatory factors.
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